A Big Deal: The Uterine Prolapse

Spring is in the air, which means calving season is in full swing here on the plains. Which also means that veterinarians get to deal with a wide range of calving problems. Now, 95%+ of the time cows calve without any help from humans whatsoever. And that’s the way we like it.

Hereford and calf

Like this cow, having a calf on her own that gets up and nurses in two hours without any help. Good job cow and calf, you deserve a gold star!

Unfortunately, every so often something goes wrong. And at those times, ranchers are the first to intervene to help the cow out. Although ranchers handle the majority of these issues, sometimes ranchers call a veterinarian to solve the problem. And one of those problems we get called for is a uterine prolapse.

A uterine prolapse is where the uterus (the organ that the calf lives and grows in during pregnancy) turns inside-out after calving and follows the calf through the pelvic canal to the outside of the cow. Obviously this is rather unsightly looking, so if you want to see what that looks like follow this link and look on the second page.

There are a number of things that contribute to this happening, such as a difficult calving, low blood calcium, or calving with the backside of the cow pointed downhill. Obviously this is a big problem that needs to be corrected quickly, as it will end up being fatal if the prolapse is not returned into the cow promptly.

Fixing a uterine prolapse is a messy task that requires quite a bit of muscle. First the cow needs to be adequately restrained, as if this isn’t done both the cow and the veterinarian can get hurt. Next, the cow receives an epidural so she cannot feel the area that will have to be worked on.

After the epidural, the uterus is washed off and excess placenta is removed. The area needs to be clean to decrease the risk of infection. If the uterus gets infected, the cow can not rebreed or even die, so the cleaner the better.

Next comes the fun part–putting the uterus back into the cow. There’s no special tricks, no secret shortcuts, or no easy ways to do this. The uterus, which weighs several dozen pounds, needs to be squeezed back through the pelvic canal and turned right side-out inside the cow. It is slimy, but usually drier than what will easily slip back in. This means it takes your arms, hands, chest, and a lot of OB lube to push it back in.

Jake in OB

This means a plastic suit like this comes in handy to make the trip back to the clinic in the pickup more comfortable.

Once the uterus is returned inside the cow, the vaginal opening is narrowed with a purse string suture. This is done to prevent the cow from pushing the uterus out again. It is left open enough to allow the cow to urinate easily. After a few weeks when the uterus has fully involuted (returned to normal, pre-pregnancy size), the stitching can be removed.

The final component is to treat the cow with an antibiotic. This is done to lower the risk of uterine infection, which would be fairly likely if the cow was not treated as one of her organs was outside of her body. If low blood calcium is suspected, the cow is also treated with IV calcium to mitigate that concern.

And that’s what it takes to treat a uterine prolapse! The cow then can be let back in with her calf so she can mother it. The cow and calf can then go back to happily frolicking in the pasture, prolapse-free.